Online Discussion Forum
March 7, 2007
Daily Digest #3
Dear forum members:
Today we received two interesting comments from Zambia and Sierra Leone. Thank you to everyone who has contributed so far! We’re sure that more of you have experiences and thoughts to share about client-provider interaction in FP/HIV settings – please e-mail fphivintegration@ibp.wa-research.ch or reply to this email.
Best,
Megan O'Brien
For the IBP Initiative
www.ibpinitiative.org
info@ibpinitiative.org
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I would like to conquer with Dr. Amenya concerning the common misconceptions about contraception. In Zambia, apart from believing that contraception causes infertility, additions are that it causes fetal abnormality, the pill piles up in the uterus to form an anthill. We also get to the users with Inter Personal Communications and IEC. What is working out best for us at Society for Family Health is that we have put in place a community initiative called "Circle of Friends" where the satisfied users are able to recruit the non users of any method from their community and introduce them to the FP provider who would take them through counselling and they will be able to choose and go away on a method. The new recruit now becomes a member of the circle and is expected to attend monthly meetings at the Health centre with the other team members. The monthly meetings' agenda consists of discussions on any RH issues, dispelling misconceptions by way of being role models to the recruits e.g. if they fear infertility, the role model should be able to prove that she has had a baby or even babies after stopping to use a contraceptive. If it is fears about fetal abnormalities, a normal child born after contraception should be presented for proof because seeing is believing. As for the pill piling up, the provider or one member of staff from SFH should be able to explain in detailed simple terms how the digestive system works and what the pill undergoes from the time it is swallowed for it to prevent pregnancy. This initiative is workable in any given health situation in communities where Behaviour Change Communications must bear health impact as the end result.
Thanks,
Jully Chilambwe,
Health Services Manager - RH
Society for Family Health
Lusaka
ZAMBIA
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Warm greetings
1. Yes, many women still have lots of misconceptions of the safety of some methods. Some responsible reasons for these are related to the cultural beliefs and male dominance in decision making common in African settings for instance the pill and IUD are misconcepted to be used by women with multiple partners and the fear that the IUD leads to infertility. The pill is found to be the most commonly used. Condom misconception is very high. Some women question their hygiene status if a man requested to use one, others believe it gives gonorrhea, others say they will not feel satisfied etc, etc. Right across, condom prevalence is very low. As many clients still object to condom use, which has proved to be the most effective method in preventing unwanted pregnancies, sti, including Hiv/Aids, it is of paramount importance that we learn to respond to client concerns and fears. For example, those who complain of lack of sensation- simple demonstration is done by wearing condom on fingers and ask client to rub the fingers on the surface, this helps them to realise that there is indeed enough sensation to make them satisfy during sex. A lot of emphasis is being placed on reinforcing information and education on condom promotion.
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I have a question for Dr Moodley
A 15 year old school girl came to our office, after some discussions, she informed us she does not see the
need to use condom or any form of contraceptive. When asked if she is sexually active she says yes, and told us her boyfriend is an older man, but they usually engaged in anal intercourse. "My mother does monthly checks on me, as far as she is concern I am a virgin". My question is, what is the short and long term effect of this practice on this 15 year old? What is our role as reproductive health workers in preventing the practice from becoming widespread?